Excessive Blinking

Introduction                                                                                                                                 The muscles on our face and eyelid are normally under our voluntary control. Facial spasm is a neurological disorder in which these muscles function abnormally and are no longer under the direct control of the brain it can affect either one small area of the face or the entire face including the neck.                                                                                                                                                                                                                    

                                                                                                                                                 Types of Spasm                                                                                                                        There are many sub-types of facial spasm, but two distinct type are very common:

1) Benign Essential Blepharospasm (BEB):                                                                                   It is caused by an uncontrolled nerve signal in the brain that stimulates the eyelid muscles. Constant involuntary blinking and squeezing of the eyelids causes visual interruptions in the patient’s day to day activities. Meige syndrome is a type of BEB that involves the entire face, not just eyelids.

2) Hemifacial spasm (HFS):                                                                                                             It is commonly caused by an irritation of facial nerve on one side, leading to involuntary spasms on one half of the face.

Treatment                                                                                                                         Botunlinum toxin injection (BOTOX) into the eyelid muscles can temporarily reduce the muscle spasm in majority of patients. The injection is performed as an out patient procedure, and takes 10-20 minutes. Application of local anesthesia cream 30 mins before the injection makes it almost painless. The effect is usually seen in 7-10 days. The effect lasts average 2-4 months, and needs to be repeated for continued effect.

Note
Botulinum toxin only controls the spasm, and does not treat it. Therefore, repeated injections are required for continued effect. Some patients may be non-responsive to Botox, and would need surgical correction of spasm. When used for treating spasms, Botulinum toxin is covered by medical insurance.